After anatomy exam this morning, I found myself feeling a bit lost, unclear, uncertain what to do with the rest of my day.  Except for a DO practical in the afternoon and a journal club meeting during the lunch hour, my schedule was pretty well barren. No lectures. No labs. No required readings. No new material to fall behind in. Within minutes of stepping out into the crisp autumn air, my quandary was resolved; I would go for a run! A nice, long run out in the country –

With finals looming just one week away and the dirt road under my feet, I reflected on the stark similarity between medical school and running — in particular, running a marathon. Upper classmates had made the comparison before while training with them in previous years, but I do not think I could fully appreciate the comparison until now.

Yes, the finish line is finally in view! What a quarter; what a run! While I admit there is much relief in the prospect of finishing, I do acknowledge the trepidation that I feel when considering all that lies between now and then — namely, the WALL, or that mythical moment when the collective effects of pain, fatigue, hunger, dehydration, and exhaustion bare down in unrelenting fashion!

So why do it? To what end?

It is the challenge, the challenge to finish — and to finish strong, to finish better than the way in which the race began! It is an exercise in self-discipline, self-control. Setting out to achieve a desired end and not wavering, faltering when everything within (and without) screams “YOU CAN’T!“. For me, the challenge is more personal than academic. It is a time to prove to myself that I really can do it  — without pretense, without presumption! Like the banner read at mile 20 at the Marine Corps Marathon in 2006, it is a time to “release [my] inner Kenyan” and set a personal best!

In short, it is a time to pick up the pace and sprint to the finish!

The following exchange illustrates a common misconception of the osteopathic profession:

Questioner: So what exactly is the difference between an MD and a DO?

MD student: The difference is that we are involved in research and they are not.

DO student (Me): Wait a minute! DOs are involved in research; that is not a fair assessment. The primary difference is in the fact that DOs practice manipulation, as well as there is a fundamental difference in philosophy.

MD student: Right! I did not mean that DOs are not involved in research . . .  but that MDs are more prone or likely to do research than DOs — historically speaking, that is.

The following are some photographs of a few of the research-oriented events held at KCOM this quarter. Perhaps that is one of the things I appreciate most about KCOM: that research is fostered, encouraged, and becoming an integral part of the KCOM curriculum!

Interdisciplinary Biomedical Research Symposium (Sat., Sept 26, 2009)

Eagerly waiting for Dr. Chang to stop by and talk to me (right) about my poster.

Nastassia Richardson, OMSI (left) discusses her graduate research with a recent graduate of the Biomedical Sciences Program, Kristi Teal, OMSII, .

Research Panel Discussion: From the Bedside to the Bench (Thurs., Oct 8, 2009)

Panelists Bill Sexton, PhD, Yingzi Chang, MD, PhD, and Eric Snider, DO discuss how to turn clinical questions into research opportunities.

It was my privilege to moderate the panel discussion.

Yesterday, after attending an OTM practice session with the fellows, I left feeling somewhat ecstatic . . . redeemed, healed! With my arms raised high above my head and eyes fixed towards the heavens, I found myself exclaiming — “I BELIEVE!”

I readily admit that my conversion did not take long. In fact, I was a believer even before coming to KCOM. That is, I was a believer in the theory behind the practice; namely, that structure defines function. What I did not completely believe in, though, was my ability to diagnose and treat dysfunctional vertebra correctly.

However, that is no longer the case. I have seen and tasted the light, and it is delicious! Not once, but twice! Yesterday it was a classmate whose spine crackled back to “normal”; and tonight it was my wife! The latter had some pain radiating into her lower extremeties — until, of course, she was introduced to the “Kirksville crunch”. “Much better,” she reported, adding, “the pain in my leg is gone”. Two different treatments with two similar results –

Yes, Dr. Still, I believe . . .

Yesterday I got through a second round of standardized patients (SP) relatively unscathed. Unlike the first round, my awkwardness in being “natural” in an otherwise “unnatural” setting while trying to cover (and remember) all the components of COPMAPS was not digitally recorded. Thankfully, neither was the smirk that came to my face upon entering the patient’s room . . . as images of Kramer presenting with gonorrhea ran through my mind!

Fortunately, the cases I encountered were not nearly as complicated (i.e., sinus infection, head pain from falling) this time around. Instead of debriefing the SP encounter with faculty one week after-the-fact, we were to receive on-the-spot feedback directly from the patient — once, of course, the patient history was complete.

It was rather refreshing (and insightful) to see the SP not as mere actors but as individuals within the community — as it did not take long before feedback became advice . . . advice regarding the importance of empathy, understanding, making the patient feel as comfortable as possible, especially when meeting them for the first time. Feedback was no longer personal but about the system. Within moments it became clear that this so-called “SP encounter” was much more than just an extracurricular activity. It was an opportunity . . . an opportunity to both listen and learn!

Today marks a graduation of sorts! Today was the first day of interviews for the class of 2014. As these eager, well-dressed hopefuls pass me in the hall looking somewhat like a deer caught in headlights, stunned, dazed, overwhelmed — or, perhaps, is it catatonic glee? –  my mind naturally reflects upon my own experience and interview almost one year ago.

The hardest question . . .

Dr. Theobald (Pharmacology Department): “If your best friend was to give a description of you and your characteristics (i.e., strengths and weaknesses), what would they say?”

The most piercing question . . .

Tim Tucker (Student Resources): “What exactly do you mean when you say [in your application] that you see yourself as a leader while at school? What kind of leader?”

With the interview season officially on its way, it seems I will have ample opportunity to reflect and reminisce with classmates . .  . swapping, sharing, and retelling war stories again and again. It is interesting to consider just how easy it is to recall the questions asked by the interviewers in all its blood and gore! Much easier than, say, the glowing portrait I painted of myself in response to their queries! Selective memory? Perhaps. Or, could it just be that I am not living up to what I professed . . . that somehow the oil on the canvas has smudged, my self-portrait flawed?

Regardless of my inability to recall the idealized responses of last year, I do have the chance to answer my interviewers’ questions now. Frightening prospect, I realize, to be a little more authentic, more real . . . to get out the oils, the easel, the canvas, if you will, and start anew! Brushing shoulders with so many potential colleagues serves as a reminder that some of the best and most enduring art is not constructed in an hour interview — but in a lifetime!

See you on campus, Class of 2014! (Oh and one more thing — do not let anyone fool you, immortality is but a bad interview away!)

Alright, so yesterday I needed a little pep talk, a little reprieve, a moment to recapture the big picture — for I was slipping, slipping fast, slipping down a spiral staircase to which there is no end! Overwhelmed with the volume of work being hurled my way, I began to ask a series of questions steeped in self-doubt: What have I done? What have I gotten myself into? Me . . . in med school? Who am I trying to kid?

(Fruitless endeavor, I know!)

Then, while talking to my study partner (another 30-something guy with lots of kids), I was reminded of all the factors that had brought me here . . . to med school, that is! The journey, if you will, the quest, my own personal narrative of pursuing medicine after spending the last 15 plus years working as a freelance sign language interpreter. I never have been able to sit restlessly and plaintively wonder “what if”. If I never give medicine an honest try, then how could I ever expect to challenge my own kids to dare the impossible . . . to scale the heights of uncertainty, to let go and experience the sheer thrill of a water slide on a hot summer day?

Yes, I believe the big picture has been recaptured! Stress, pressure, sleep deprivation, unfair exam questions, and the irritability that comes with each . . . all of which are factors that must be reckoned with daily, kept in check and balanced! The implications of White Coat Ceremony are beginning to ripen. The attitudes, the mindset, the very habits cultivated (and magnified) in the midst of so many stressors will, to a large extent, determine how I handle the stress of non-compliant patients, an unstable economy and healthcare system, the ravages of war and terrorism . . . .

No doubt, a precedent is being set — as little eyes take interest in the scene that unfolds before them! Yes, these next four years need to be enjoyed! If not for my sake, then for theirs!

It hasn’t even been a month yet, and already the excitement and thrill of “arriving” in med school is beginning to wane. It could be due, in part, to the fact that this weekend is full of first exams (Biochemistry on Friday; Anatomy on Monday). To say that the “honeymoon” is over may still be a bit premature — as is evidenced by the following exchange (which took place the first week of classes).

Me: “Dr Rhodes [histology professor], I understand that you really turn up the heat in the 2nd quarter?”

Dr Rhodes (smiling wryly): “The heat is already on; the 2nd quarter is when you reach boiling point!”

Perhaps that explains the feeling that has permeated the campus these past few days. Tension, unease, unrest . . . the prospect is grim: sitting in a pot of water, waiting anxiously, knowing that the temperature is slowly rising and will soon be unbearable! It is quite unsettling; yet, I find it somewhat reassuring! For, unlike the frog that finds itself in a similar predicament, death is not the intended outcome!

It seems hard to believe, but medical school has FINALLY arrived! The journey getting here has been long and arduous (13 years to be exact), and looming ahead is the promise that this is not the end but merely the beginning! As is customary, today marked a very significant milestone in that we received our “white coat”, which symbolizes our induction into the profession as physicians-to-be. The notion that our life as a physician begins NOW and not upon graduation was stressed again and again. I find this quite encouraging! Given the fact that I will graduate from medical school one month after turning the BIG 40, it is comforting to know that my life for these next four years is not “wasting away” while awaiting for my new career to begin. It is an exciting time, indeed — knowing that the means are an essential and integral part of the end!

The source of my support -- my wife, April!

Introducing myself prior to donning a new "white coat".

Graduates of the Biomedical Sciences Program: the most who have matriculated into KCOM since the Program's inception in 2001.